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Immediate versus delayed loading of strategic mini-implants under existing removable partial dentures: patient satisfaction in a multi-center randomized clinical trial

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Abstract

Objective

The purpose of this study was to evaluate and compare the effects of the immediate and delayed loading of strategic mini-implants (MIs) on the satisfaction of patients with removable partial dentures (RPDs).

Materials and methods

In this multi-center randomized clinical trial, strategic MIs were inserted under 79 RPDs in 76 participants. Two questionnaires, one for the upper jaw and one for the lower jaw, were given before surgical intervention and 2 weeks, 4 months, 4.5 months, 1 year, 2 years, and 3 years after implant insertion. To estimate the loading effect (immediate vs. delayed) in terms of the odds ratio, an ordinal logistic regression model was used. The Wilcoxon matched-pairs signed-rank test, which was corrected for clusters in the patient population, was used to evaluate changes in patient satisfaction.

Results

After 4 months, a statistically significant difference in favor of the immediate loading group was recognized in terms of the overall satisfaction score. The patient satisfaction scores recorded after 4.5 months and 1, 2, and 3 years showed substantial improvements compared with the scores recorded before implant insertion in both groups. At the item level, substantial improvements were noted in the following domains: general satisfaction, RPD retention, stability, support, eating, speaking, and aesthetics.

Conclusions

Strategic MIs improved the satisfaction of patients with RPDs during the medium-term follow-up period. An earlier improvement in the satisfaction of patients with RPDs was seen after immediate loading of the MIs as compared with delayed loading.

Clinical relevance

Inserting MIs under existing RPDs can improve patients’ satisfaction with their RPDs in several domains.

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Funding

This study was financially supported by 3M Deutschland GmbH, Germany. 3M ESPE provided the implants and other implant materials.

Author information

Authors and Affiliations

  1. Department of Prosthodontics, Gerodontology and Dental Materials, Greifswald University Medicine, Greifswald, Germany

    Ahmad Al Jaghsi, Friedhelm Heinemann, Reiner Biffar & Torsten Mundt

  2. Restorative Department, College of Dentistry, Ajman University, University Street, Al jerf 1, Ajman, United Arab Emirates

    Ahmad Al Jaghsi

  3. Private Practice, Morsbach-, Lichtenberg, Germany

    Friedhelm Heinemann

Authors
  1. Ahmad Al Jaghsi
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  2. Friedhelm Heinemann
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  3. Reiner Biffar
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  4. Torsten Mundt
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Contributions

AA: drafting the article, RCT coordinator, data acquisition, patients’ examiner, and treatment plan; FH: study design, patients’ treatment, and critical revision and approval of the article; RB: study design and critical revision and approval of the article; TM: treatment concept, RCT design, RCT director, and critical revision and approval of the article

Corresponding author

Correspondence to Ahmad Al Jaghsi.

Ethics declarations

The study was designed according to the Good Clinical Practice guidelines (ICG-GCP) and the principles of the Declaration of Helsinki, as revised in 2008. The protocol of the RCT followed the SPIRIT guidelines.

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

The study was approved by the Ethics Committee of the University of Greifswald (BB 058/13A) and, secondarily, by the authorized Ethics Committees of the other centers (Ethics Committee of the Medical Council Nordrhein No. 2013336; Ethics Committee of the Medical Council Westfalen-Lippe, 2013-406-b-S).

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Al Jaghsi, A., Heinemann, F., Biffar, R. et al. Immediate versus delayed loading of strategic mini-implants under existing removable partial dentures: patient satisfaction in a multi-center randomized clinical trial. Clin Oral Invest 25, 255–264 (2021). https://doi.org/10.1007/s00784-020-03360-y

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